Hyuga Taiju, Sugimura Koki, Moriya Kimihiko
Department of Pediatric Urology Jichi Medical University, Children's Medical Center Tochigi Shimotsuke Japan.
IJU Case Rep. 2025 Apr 23;8(4):334-337. doi: 10.1002/iju5.70032. eCollection 2025 Jul.
Generally, lower urinary tract function is considered to show few changes in adulthood for cases of spina bifida.
The case involved a 33-year-old man with a primary diagnosis of spinal lipoma. Urological management by spontaneous voiding was maintained, and uroflowmetry at 23 years old showed a maximum flow rate of 9.6 mL/s and a residual urine volume of 35 mL; then urological follow-up was ended. The patient developed nocturnal enuresis and daytime urinary incontinence. Residual urine was exceeding 500 mL. Bladder deformity was identified on VCUG. UDS showed a high storage pressure with compliance of 5.0 mL/cmHO. CIC management was introduced, and vibegron was initiated. After that, the urinary symptoms were resolved immediately. On video-UDS, bladder deformity and compliance had improved.
Patients managed by spontaneous voiding should be carefully evaluated for atypical UDS findings to decide whether urological follow-up can be considered complete.
一般来说,对于脊柱裂患者,成年后下尿路功能被认为变化不大。
该病例为一名33岁男性,初步诊断为脊髓脂肪瘤。维持自主排尿的泌尿外科管理,23岁时尿流率检查显示最大尿流率为9.6毫升/秒,残余尿量为35毫升;随后结束泌尿外科随访。患者出现夜间遗尿和白天尿失禁。残余尿量超过500毫升。排尿性膀胱尿道造影显示膀胱畸形。尿动力学检查显示储尿期压力高,顺应性为5.0毫升/厘米水柱。开始间歇性导尿管理并使用维贝格隆。此后,尿路症状立即得到缓解。在影像尿动力学检查中,膀胱畸形和顺应性有所改善。
对于采用自主排尿管理的患者,应仔细评估非典型尿动力学检查结果,以决定是否可认为泌尿外科随访已完成。